Substance abuse

Drug addiction, also called substance use disorder, is a disease that affects a person’s brain
and behavior and leads to an inability to control the use of a legal or illegal drug or medicine.
Substances such as alcohol, marijuana and nicotine also are considered drugs. When you’re
addicted, you may continue using the drug despite the harm it causes.Substance abuse refers
to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.
One of the key impacts of illicit drug use on society is the negative health consequences
experienced by its members. Drug use also puts a heavy financial burden on individuals,
families and society.
Pathophysiology

Causes

 . Environmental factors
 Genetics
 Numerous biological, psychological, and sociocultural
 Factors may cause alcoholism and drug abuse. Family
 Background may play a significant role, as the child of one
 Alcoholic parent is seven to eight times more likely to become
 An alcoholic than a peer without such a parent.

Risk factors

 Family history of addiction.

 Mental health disorder.
 Peer pressure..
 Lack of family involvement.
 Early use
 Taking a highly addictive drug

Clinical Manifestations
In pediatric patients, clinical manifestations of substance abuse can vary depending on the
substance involved. Common signs may include changes in behavior, mood swings, declining
academic performance, changes in sleep patterns, increased secrecy, sudden weight loss or
gain, dilated or constricted pupils, and physical symptoms such as tremors or slurred speech.
It’s crucial to monitor for these signs and seek professional help if substance abuse is
suspected.

Labs/Diagnostic Exam

 urine drug tests,

 blood tests
 psychological assessments.
 saliva tests can confirm drug use and blood
 Alcohol level, determine the amount and type of substance taken, and reveal
complications.
These help identify substance use, its effects, and any underlying mental health issues.
Additionally, pediatricians may conduct interviews with both the child and their family to
gather comprehensive information.

NURSING INTERVENTION

 Provide an opportunity to choose foods and snacks to meet the dietary plan.
 Improving Sexual Functioning
 Promote the intake of foods rich in fatty acids.
 Provide a diet rich in essential macro- and micronutrients.
 Encourage the client to practice good oral hygiene.
 Encourage family members to seek help whether or not the abuser seeks it.
 Provide positive feedback for expressing awareness of denial in self and others.
 Provide information regarding the effects of addiction on mood and personality.
 Discuss the client’s current life situation and the impact of substance use.
 . Helping the Patient to Accepting Reality
 Remove harmful objects from the client’s room.
 Maintain a quiet, safe environment during withdrawal from any drug.
 Assist the client to learn and encourage the use of relaxation skills, guided imagery, and
visualizations.
 Encourage verbalization of feelings, fears, and anxiety.
 Determine outside stressors and other causes of SUD.
 Encourage the client to utilize telemedicine for recovery support services.
 Encourage family members to seek help whether or not the abuser seeks it.
 Assist the client to learn own responsibility for recovering.
 Discuss the potential for re-emergence of withdrawal symptoms in stimulant abuse as
early as three months or as late as 9 to 12 months after discontinuing use.
 Provide an active role for the client and family members in the learning process
(discussions, group participation, role-playing).
 Assess the client’s readiness for change.
 Promoting Support and Self-Esteem
 Provide a safe, non-threatening environment.

Prevention
The best way to prevent an addiction to a drug is not to take the drug at all. If your health care
provider prescribes a drug with the potential for addiction, use care when taking the drug and
follow instructions.

 Preventing drug misuse in children and teenagers

 Take these steps to help prevent drug misuse in your children and teenagers:
 Communicate. Talk to your children about the risks of drug use and misuse.
  Listen. Be a good listener when your children talk about peer pressure and be supportive
of their efforts to resist it.
 Strengthen the bond.

Treatment
Although there’s no cure for drug addiction, treatment options can help you overcome an
addiction and stay drug-free.

 Withdrawal therapy
 Opioid overdose
 Medicine as part of treatment
 Behavior therapy
 Rehabilitation (rehab):

Complications

Most body tissues can be adversely affected by the heavy intake of alcohol, and death
can occur from abrupt alcohol withdrawal. Chronic drug abuse, especially intravenous
(I.V.) use, can lead to life-threatening complications, including:

 cardiac and respiratory arrest, subacute bacterial endocarditis, Pulmonary emboli, and
respiratory infections
 intracranial hemorrhage
 vasculitis, thrombophlebitis, and gangrene
 Musculoskeletal dysfunction
 acquired immunodeficiency syndrome (AIDS) and hepatitis
 tetanus, septicemia, and malaria
 malnutrition
 trauma
 depression, psychosis, and increased risk of suicide.

MEDICATION
 Medications used in substance abuse treatment vary depending on the substance of
abuse. They can include medications such as disulfiram, acamprosate, and naltrexone
for alcohol use disorder, methadone, buprenorphine, and naltrexone for opioid use
disorder, and nicotine replacement therapy, bupropion, and varenicline for nicotine
dependence, among others. These medications are often used as part of a
comprehensive treatment approach that includes counseling, behavioral therapies, and
social support to help in recovery.
 Alcohol abuse disorder
Disulfiram
This drug can be helpful in maintaining abstinence from alcohol while another therapy is
undertaken. By inhibiting alcohol oxidation, the drug leads to an accumulation of
acetaldehyde with a highly unpleasant reaction if alcohol is consumed. These
unpleasant reactions include headache, nausea, vomiting, flushing, dizziness, and
weakness (Jahan & Burgess, 2022).

Acamprosate
This helps prevent relapses in alcoholism by lowering receptors for the excitatory
neurotransmitter glutamate. This agent may become the drug of choice because it does
not make the user sick if alcohol is consumed; it has no sedative, antianxiety, muscle
relaxant, or antidepressant properties, and produces no withdrawal symptoms. It is
important to include vitamin B1 and vitamin B9, along with multivitamins, to address any
nutritional deficiencies (Jahan & Burgess, 2022).

Naltrexone and nalmefene

These are used to suppress craving for opioids and may help prevent relapse in the
client abusing alcohol. Current research suggests that naltrexone suppresses the urge to
 continue drinking by interfering with the alcohol-induced release of endorphins (Jahan &
Burgess, 2022).

 Opioid use disorder

Methadone
This drug is thought to blunt the craving or diminish the effects of opioids and is used to
assist in withdrawal and long-term maintenance programs. It can allow the individual to
maintain daily activities and ultimately withdraw from drug use. Methadone can only be
used to treat opioid use disorder by specific treatment facilities designated as Opioid
Treatment Programs (OTPs) (Jahan & Burgess, 2022).

Buprenorphine
A partial opioid agonist that can reduce withdrawal symptoms and cravings, also used in
MAT programs.

Naltrexone
Blocks the effects of opioids and reduces cravings by binding to opioid receptors.

Nicotine Dependence
Nicotine Replacement Therapy (NRT) (nicotine gum, patches, lozenges, inhalers, and
nasal sprays)
These can deliver controlled amounts of nicotine to help reduce withdrawal symptoms
and gradually wean off tobacco.

Bupropion
An antidepressant that can reduce nicotine cravings and withdrawal symptoms.

Varenicline
Helps reduce nicotine cravings and withdrawal symptoms by blocking nicotine receptors
in the brain

Reference: https://nurseslabs.com/substance-abuse-nursing-diagnosis-care-plan/